REGISTER | Dissociation in Relational Context Study Group 11/8

Houston Psychoanalytic Society

Study Group

Dissociation in Relational Context

Facilitated by

Jon G. Allen, PhD & Shweta Sharma, PsyD

5 Tuesdays

November 8 - December 13, 2022

7:00 PM - 8:30 PM Central Time

Live via Zoom

*Pre-Registration required for Zoom invitation

Registration Fees

Active Members: $150

Friend Members: $175

Student Members: $75

Non-members: $200

7.5 CE/CME/CEUs Instructional Level: Intermediate to Advanced

Dissociation has a long and controversial history within psychoanalysis and in psychiatry more generally, partly owing to its common conjunction with early relational trauma. Dissociation is distinguished in various ways from related concepts, including repression, regression, splitting, defense, and conflict. All these concepts relate to our understanding of conscious and unconscious processes, adaptive and maladaptive. Moreover, each of these concepts is understood in different ways in different traditions of psychoanalytic thought over the course of more than a century. Now we toss the brain and its unfathomable multiplicity into the conceptual mix. The ultimate irony; at times, dissociation and childhood trauma have been dissociated from the field of psychiatry and psychoanalysis.

A study group is an ideal forum for sorting out the conceptual tangle surrounding dissociation, without any pretense of aspiring to a neat formulation. Puzzling as it can be, dissociation has the advantage of being a fascinating window into the organization and disorganization of mind and relatedness. At the same time, dissociation can be problematic—and sometimes downright alarming and disorienting—in clinical practice. Each of us must find some way of understanding dissociation and related concepts to work effectively with our patients, especially those with a history of early relational trauma.

We thank JoAnn Ponder for suggesting this study group and for assembling a set of evocative psychoanalytic articles as a stimulus for thinking. The purpose of the group is to share our understanding and confusion, particularly as it relates to our personal clinical experience, so as to learn together. We have organized the readings into five groups, but their overlap in topics and often conflicting themes is more substantial than their distinctness. Our goal is illumination; resolution of conflict is up to us individuals.

OBJECTIVES

1a) Give one to two examples of your clinical experience with dissociation.

1b) Describe how dissociation is evident in infancy in relation to maternal behavior.

1c) Give the rationale for integrating treatment of unrepresented states and symbolized aspects of intrapsychic conflict.

2a) Explain the meaning of the term “unformulated experience.”

2b) Describe how enactments are processed to treat early relational trauma.

3a) Describe four implicit binaries that update Freud’s unitary conception of repression.

3b) Explain what Bornstein means by repression of the “whole person.”

4a) Explain what Bromberg means by “standing in the spaces.”

4b) Describe the importance of Bromberg’s distinction between the “content” of an interpretation and the “person” who offered it (p. 27).

5a) Explain the sense in which the id is conscious and the ego is unconscious.

5b) Describe the clinical value, if any, of relating dissociation and repression to brain functions and locations.

Facilitators

Jon G. Allen, PhD, retired from clinical practice in 2016 as Professor of Psychiatry, Menninger Department of Psychiatry and Behavioral Sciences at the Baylor College of Medicine. He is a member of the Houston Psychoanalytic Society and an honorary faculty member of the Center for Psychoanalytic Studies in Houston. He received postdoctoral training and practiced for 40 years at The Menninger Clinic, first in Topeka, Kansas then in Houston, Texas. Since retirement, he has continued to teach and write as well as consulting regarding research and psychotherapy. He served as Editor of the Bulletin of the Menninger Clinic from 1987-1998 and also served for several years on the editorial board of Trauma and Dissociation. In the late 1980s, he joined a group of colleagues in establishing an intensive, long-term inpatient treatment program specializing in treatment of trauma-related disorders, wherein dissociation was the most prominent and problematic problem. For many years, along with diagnostic evaluations, psychotherapy, and research, he conducted intensive psychoeducational groups focusing on trauma and dissociation. He has written about dissociation and trauma in several books and journal articles. His latest book is Trusting in Psychotherapy (American Psychiatric Association Publishing, 2022), which includes discussion of relational psychoanalysis as exemplifying trustworthiness in conducting psychotherapy.

Shweta Sharma, PsyD, is a Licensed Psychologist who currently serves as a senior staff psychologist at The Menninger Clinic and as an Assistant Professor of Psychiatry in the Menninger Department of Psychiatry and Behavioral Science at Baylor College of Medicine in Houston, Texas. She is an advanced candidate in the adult psychoanalysis training program at the Center for Psychoanalytic Studies in Houston. She previously completed training on the Diagnoses and Treatment of Dissociative Disorders, sponsored by International Society for the Study of Trauma and Dissociation. She is a member of American Psychoanalytic Association, Houston Psychoanalytic Society, and ISSTD. Her clinical work focuses on the assessment and treatment of young adults. Dr. Sharma is involved in performing intensive diagnostic evaluations, conducting individual and group psychotherapy, and co-facilitating psychoeducational groups focusing on trauma and dissociation. Her work has been published in the journal of Psychoanalytic Study of the Child and APA's Psychotherapy journal.

Schedule/Syllabus/References

Session 1, November 8: Varieties of Dissociative Experience

Allen, J. G. (2022). Dissociation and Connection (unpublished).

Allen, J. G. (2001). Dissociative disorders. In J. G. Allen (2013). Restoring mentalizing in attachment relationships: Treating trauma with plain old therapy (pp. 71-89). Washington, DC: American Psychiatric Publishing.

Busch, F. N. (2017). A model for integrating actual neurotic or unrepresented states and symbolized aspects of intrapsychic conflict. Psychoanalytic Quarterly, 86:75-108.

Session 2, November 15: Dissociation and Relational Trauma

Stern, D. B. (2019). Unformulated experience and the relational turn. Psychoanalytic Inquiry, 39: 127-135.

Davies, J. M., & Frawley, M. G. (1991). Dissociative processes and transference-countertransference paradigms in the psychoanalytically oriented treatment of adult survivors of childhood sexual abuse. Psychoanalytic Dialogues, 2: 5-36.

*Bromberg, P. M. (2008). Shrinking the tsunami: Affect regulation, dissociation, and the shadow of the flood. Contemporary Psychoanalysis, 44: 329-350. [trauma]

*Busch, F. (2005). Conflict theory/trauma theory. Psychoanalytic Quarterly, 74: 27-45.

Session 3, November 29: Dissociation, Repression, and Regression

Akhtar, S. (2020). Repression: A critical assessment and update of Freud's 1915 paper. American Journal of Psychoanalysis, 80: 241-258.

Bornstein, M. (2013). Dissociation and repression: A clinical study. Psychoanalytic Inquiry, 33: 439-448.

*Sugarman, A. (1995). Psychoanalysis: Treatment of conflict or deficit? Psychoanalytic Psychology, 12: 55-70.

Session 4, December 6: Creating Unity in Multiplicity

Bromberg, P. M. (1996). Standing in the spaces: The multiplicity of self and the psychoanalytic relationship. Contemporary Psychoanalysis, 32: 509-535.

Bromberg, P. M. (2010). Minding the dissociative gap. Contemporary Psychoanalysis, 46: 19-31.

*Bromberg, P. M. (1991). On knowing one's patient inside out: The aesthetics of unconscious communication. Psychoanalytic Dialogues, 1: 399-422.

Session 5, December 13: Neuropsychoanalytic Perspectives

Smith, R. & Solms, M. (2018) Examination of the hypothesis that repression is premature automatization: A psychoanalytic case report and discussion. Neuropsychoanalysis, 20: 47-61.

Mucci, C. (2021). Dissociation vs repression: A new neuropsychoanalytic model for psychopathology. American Journal of Psychoanalysis, 81: 82-111.

*Optional readings Silhouette image from Shutterstock

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